title: Electrical or repetitive transcranial magnetic stimulation of primary motor cortex for intractable neuropathic pain.
abstract: OBJECTIVE
  To assess the pain-relieving effects of motor cortex electrical stimulation (MCS) and the predictive factors retrospectively.
  
  
  METHODS
  Thirty-four patients with intractable neuropathic pain underwent MCS; 19 patients had cerebral lesions, and 15 had non-cerebral lesions. In selected 12 patients, test electrodes were implanted within the central sulcus and on the precentral gyrus. Twelve patients received both MCS and repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex.
  
  
  RESULTS
  Pain reduction of >50% was observed in 12 of 32 (36%) patients with >12 months follow-ups (2 patients were excluded because of short follow-up). In 10 of the 12 patients who received test electrodes within the central sulcus and on the precentral gyrus, the optimal stimulation was MCS within the central sulcus. In 4 of these (40%) patients, positive effects were maintained at follow-ups. The pain reduction of rTMS significantly correlated with that of MCS during test stimulation.
  
  
  CONCLUSIONS
  The test stimulation within the central sulcus was more effective than that of the precentral gyrus. In the selected patients, chronic stimulation within the central sulcus did not significantly improve long-term results. Repeated rTMS seems to be same effective as MCS.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Maruo
authors.forename: Masaru
authors.initials: M
authors.lastname: Yokoe
authors.forename: Taiga
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: Masaki
authors.initials: M
authors.lastname: Sekino
mesh_terms: D000328:Adult; D000368:Aged; D004558:Electric Stimulation; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D009437:Neuralgia / Q000503:physiopathology* / Q000628:therapy; D010146:Pain; D059408:Pain Management; D010147:Pain Measurement; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D020521:Stroke / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation